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I feel like although the earlier commenters made it out like it's so 'uncommon', it's not at all

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Nervous system effects: In rare cases, tingling, weakness, or numbness may occur

You may be able to continue treatment with a few tweaks in the administration method

Anti-Inflammatory Effects Some evidence suggests Nicotinamide N-methyltransferase (NNMT) inhibition may help reduce inflammation, which is linked to various chronic diseases

NAD Nasal Spray: Gaining Traction With a push to make NAD+ supplements more accessible, nasal sprays have emerged as a compelling alternative to injections and oral supplements